the power of DSD
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Diagnostic<br />
impressions and casts
Diagnostic<br />
upper cast
Diagnostic<br />
Lower cast
Pat. Merna Zakaria<br />
Date:30/10/2018<br />
Dr. Emad Adel<br />
Class 3 Max./Man. Relationship<br />
Shift in <strong>the</strong> mid line with no canting<br />
cover photo
Facial Frontal<br />
Smile<br />
Facial Frontal<br />
Retracted
Pr<strong>of</strong>ile<br />
Relaxed<br />
Pr<strong>of</strong>ile Pr<strong>of</strong>ile<br />
Smile Retracted
12 o’clock<br />
Only lower teeth are visible
Upper cast<br />
analysis
Smile analysis<br />
Counting<br />
Interview<br />
Video
Smile analysis<br />
Counting<br />
Interview<br />
Video
Facial lines and<br />
curves
Simile line parallelism<br />
to lower lip line
synchronizing
cropping
Transferring imp lines
calibrating<br />
75%
Golden proportion
Teeth selection
Morpho psychology - Visagism<br />
Sensible Dynamic Strong Calm<br />
Oval Triangular Rectangular Square<br />
Organized<br />
Perfectionist<br />
Artistic<br />
Abstractive<br />
Timid<br />
Reserved<br />
Extroverted<br />
Communicative<br />
enthusiastic<br />
Dynamic<br />
I mpulsive<br />
Determined<br />
Objective<br />
Explosive<br />
I ntense<br />
entrepreneur<br />
Passionate<br />
Diplomatic<br />
Pacific<br />
Mystic<br />
spiritualized<br />
Conformist<br />
Discreet
Oval<br />
Dominant Centrals<br />
Rounded cusps<br />
Delicate laterals<br />
Round Arch<br />
Sensible<br />
Melancholic<br />
Organized<br />
Perfectionist<br />
Artistic<br />
Abstractive<br />
Timid<br />
Reserved
Triangular<br />
Ascendant Smile Line<br />
Converging Axis<br />
Incline cusps<br />
Dynamic<br />
Sanguine<br />
Extroverted<br />
Communicative<br />
enthusiastic<br />
Dynamic<br />
I mpulsive
Rectangular<br />
Dominant Centrals<br />
Flat incisal edge<br />
Aggressive Cusps<br />
Vertical Axis<br />
Strong<br />
Choleric<br />
Determined<br />
Objective<br />
Explosive<br />
I ntense<br />
entrepreneur<br />
Passionate
Square<br />
Lack <strong>of</strong> Dominance<br />
Diverging Axis<br />
Horizontal arrangement<br />
Calm<br />
Phlegmatic<br />
Diplomatic<br />
Pacific<br />
Mystic<br />
spiritualized<br />
Conformist<br />
Discreet
Teeth outline
Mesurments
Oval
Oval
Oval opaque
Triangular
Triangular
Oval translucent
Oval Opaque
Oval Opaque
t<br />
Triangular teeth
Oval teeth
val vs triangular teeth
She Had Selected <strong>the</strong> Triangular<br />
teeth form
So!<br />
How to transform this design<br />
to our real life
So!<br />
How to transform this design<br />
to our real life
By Measurement only ?!<br />
Is it accurate enough?
Mesurments<br />
By Measurement only ?!<br />
Is it accurate enough?
1.Graph paper
New invention
The printing view
The previous outline was<br />
printed on Transparent paper
Super impose on <strong>the</strong> cast
The final templete after<br />
cutting
Building up by composite resin
The clinical Mock-up<br />
Let`s see <strong>the</strong> difference
The Initial<br />
situation
Putty index containing temporary crown material
Just a mock up
• The mock-up was fabricated<br />
using resin based temporary<br />
crown material <strong>of</strong> an A2<br />
shade.
Lower lip coincides with <strong>the</strong> smile line
The form and teeth design was highly accepted by<br />
our patient BUT <strong>the</strong> shade was slight brighter than<br />
her lower teeth which appear during smiling
Intra oral preparation
Depth cutter marking
Depth cutter marks
Marking <strong>of</strong> depth cutter<br />
By using a non toxic pencil
The preparation
The preparation
The preparation
Retraction cord<br />
application
• Shade selection using 3D master shade guide<br />
system<br />
• The shade was controled by that <strong>of</strong> lower<br />
teeth because <strong>the</strong> patient has a low lip line
Shade<br />
selection
Impression<br />
• The impression was taken using<br />
a putty consistency addition<br />
silicon impression material that<br />
serves as a tray for <strong>the</strong> light<br />
consistency addition silicon<br />
impression material.
Putty<br />
impression<br />
using addition<br />
silicon<br />
impression<br />
material
The veneers<br />
has been<br />
arrived
The final product<br />
The final outcome
The final outcome
The happy day<br />
The day <strong>of</strong> Cementation
• Obtra_dam<br />
Isolation
• Venere cementation<br />
protocol
• Phosphoric acid<br />
etching
• Phosphoric aci<br />
etching
Chalky white appearance<br />
after etching
• Sialination
• Cement application
Cement<br />
application
• After cementation
Shade<br />
matching
The New<br />
smile
Now <strong>the</strong><br />
upper only<br />
appear
It`s all abut <strong>the</strong> smile
• Good Bye
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